Effect of MUC5B mutation on prognosis by enhancing the infiltration and antitumor immunity of cytotoxic T lymphocytes in the endometrial cancer.
e18105 Background: Endometrial cancers have been categorized into four genomic classes by The Cancer Genome Atlas Research Network (TCGA) with comprehensive genomic analysis. However, TCGA molecular subtypes are hard to utilize in clinic as the expensive cost and a simply version of POLE, TP53 genes cannot fully differentiate the four subtypes. Therefore, more convenient and reliable biomarkers need to be identified for clinical practice. Methods: Whole-exome sequencing and RNA sequencing data for 515 patients with endometrial carcinomas were downloaded from TCGA. Associations between MUC5B mutation and survival and RNA expression were analyzed. Results: MUC5B mutation was associated with a prolonged disease specific survival (DSS) (HR, 0.47; 95% CI, 0.28-0.79; P < 0.05), progression-free survival (PFS) (HR, 0.31; 95% CI, 0.17-0.56; P < 0.001) and overall survival (OS) (HR, 0.29; 95% CI, 0.14-0.60; P = 0.001) in endometrial cancers. MUC5B mutation was significantly associated with patients' age at diagnosis (P = 0.027) and histological type (P < 0.001) and grade (P < 0.001). In the multivariable cox proportional hazards regression model including FIGO 2008, histology types, tumor grade, tp53, pole and TCGA molecular subtypes, the association between MUC5B mutation and PFS was still significant (HR, 0.40; 95% CI, 0.20-0.81; P = 0.011), indicating the MUC5B mutation is an independent prognostic factor for PFS. Moreover, MUC5B mutation have a tendency for a favorable OS (HR, 0.52; 95% CI, 0.23-1.22; P = 0.13). Patients harboring MUC5B have a higher tumor mutation burden (TMB). An analysis of immune signature revealed that MUC5B mutation was involved with the increase of genes related to activated T cells, immune cytolytic activity, and IFN-γ release. These results have further been confirmed by GSEA. Moreover, an increased level of cytotoxic T lymphocytes infiltration was observed in the patients with MUC5B mutations. Conclusions: MUC5B mutation was related with a favorable prognosis through increasing T cells signature. Identification of MUC5B mutation by genomic profiling provides a potentially novel and convenient approach for endometrial cancer patients to predict the prognosis.